微通道经皮肾穿刺造瘘钬激光治疗输尿管上段结石伴息肉56例报告

目的探讨微通道经皮肾穿刺造瘘钬激光碎石及息肉切除术治疗输尿管上段结石伴息肉的临床效果.方法回顾性分析56例输尿管上段结石伴息肉患者行微通道经皮肾钬激光碎石及息肉切除的治疗.结果 56例患者碎石成功率为100%,结石取净率为98.2%（55/56）,1例患者结石碎屑下移.手术时间平均32min,出血量平均80mL,术后平均住院时间为6.3d,双＂J＂管留置4～12周,拔除双＂J＂管后随访6个月输尿管无狭窄,肾积水明显改善或消失.结论微通道经皮肾穿刺造瘘钬激光碎石及息肉切除术治疗输尿管上段结石伴息肉具有创伤小、安全有效、恢复快的优点,有一定的临床应用价值.

Microchannel Percutaneous Nephrostomy with Holmium Laser for Treating Upper Ureteric Calculi Complicated by Ureteric Polyps in 56 Cases

Objective To investigate the clinical efficacy of microchannel percutaneous nephrostomy with holmium laser for treating upper ureteric calculi complicated by ureteric polyps.Methods 56 cases of upper calculi complicated by ureteric polyps treated by holmium laser were analyzed retrospectively.Results The total successful rate of lithotrity was 100% and the overall stone clearance rate was 98.2% （55/56）.Stone fragments moved to downward in 1 case.The mean operation time was 32 minute and the mean blood loss was 80 mL.The averaged hospital stay was 6.3 days after operation.Double J stents were removed during 4 weeks to 12 weeks after operation.All patients had been followed-up for 6 months after removed double J tube.No ureteral stricture was found and hydronephrosis was significantly decreased or disappeared.Conclusion Microchannel percutaneous nephrostomy with holmium laser is a minimally invasive,effective and safe teatment for upper ureteric calculi complicated by ureteric polyps;it is valuable in clinical application.